This article investigates the complex relationships between citizens’ perceptions about the government’s social responsibility, their satisfaction with public services and their trust in government institutions. It uses data from a national survey of citizens in Israel and focuses on satisfaction with health care. We build on previous bureaucratic and administrative theory, and suggest two competing models of these relationships: (1) perceptions about the government’s social responsibility are a source of citizens’ satisfaction and trust; and (2) perceptions about the government’s social responsibility are an outcome of citizens’ satisfaction and trust. Our findings demonstrate the important role of public perceptions about the government’s social responsibility, as well as the perceived performance of public health-care services, in building trust among citizens. The article also highlights the methodological challenges of determining cause and effect in research on trust.